title: Prevalence and spectrum of PITX2c mutations associated with congenital heart disease.
abstract: Congenital heart disease (CHD) is the most common form of birth defect and is the leading noninfectious cause of infant death. A growing body of evidence demonstrates that genetic risk factors are involved in the pathogenesis of CHD. However, CHD is a genetically heterogeneous disease and the genetic defects underlying CHD in an overwhelming majority of patients remain unclear. In this study, the whole coding region and splice junction sites of the PITX2c gene, which encodes variant 3 of paired-like homeodomain transcription factor 2 crucial for normal cardiovascular morphogenesis, were sequenced in 382 unrelated patients with CHD, and 2 novel heterozygous mutations, p.W147X and p.N153D, were identified in 2 unrelated patients with CHD, respectively, including a 1-year-old male patient with double outlet right ventricle in combination with ventricular septal defect and a 4-year-old female patient with ventricular septal defect. The mutations were absent in 400 control chromosomes and were both predicted to be disease-causing by MutationTaster. Multiple alignments of PITX2c proteins across species displayed that the altered amino acids were completely conserved evolutionarily. Functional analysis revealed that the mutated PITX2c proteins were associated with a significantly reduced transactivational activity compared with their wild-type counterpart. These findings provide a novel insight into the molecular mechanisms implicated in CHD, suggesting potential implications for the antenatal prophylaxis and allele-specific treatment of CHD.
authors.affiliation: 1 Department of Cardiovascular Medicine, East Hospital, Tongji University School of Medicine , Shanghai, China .
authors.forename: Juan
authors.initials: J
authors.lastname: Wang
authors.forename: Yuan-Feng
authors.initials: YF
authors.lastname: Xin
authors.forename: Wen-Jun
authors.initials: WJ
authors.lastname: Xu
authors.forename: Zhong-Min
authors.initials: ZM
authors.lastname: Liu
authors.forename: Xing-Biao
authors.initials: XB
authors.lastname: Qiu
authors.forename: Xin-Kai
authors.initials: XK
authors.lastname: Qu
authors.forename: Lei
authors.initials: L
authors.lastname: Xu
authors.forename: Xin
authors.initials: X
authors.lastname: Li
authors.forename: Yi-Qing
authors.initials: YQ
authors.lastname: Yang
mesh_terms: D000328:Adult; D000595:Amino Acid Sequence; D000818:Animals; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D005260:Female; D014644:Genetic Variation; D006330:Heart Defects, Congenital / Q000453:epidemiology / Q000235:genetics*; D018398:Homeodomain Proteins / Q000737:chemistry / Q000235:genetics*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009154:Mutation; D010641:Phenotype; D015995:Prevalence; D016415:Sequence Alignment; D014157:Transcription Factors / Q000737:chemistry / Q000235:genetics*; D000097577:Homeobox Protein PITX2
chemical_list: D018398:Homeodomain Proteins; D014157:Transcription Factors; D000097577:Homeobox Protein PITX2